WTC facade inspection form, 75 Broad Street

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: 1 ç 8

BIo( k: Residential D CommercialD Name of Building: Lot: Mix Use 0 Other # of Stories: AKA's: Building Owner/Management: Telephone Number: ( ) Name: FAX: Address: On Site. Contact: Name: ' Telephone Number: Building Owner Management Activities Interior Survey Performed ❑ Yes ❑ No Exterior Survey Performed ❑ Yes ❑ No General Clean Up ❑ Yes ❑ No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring ❑ Yes ❑ No Locations: Copies of All Reports and Data Requested Yes Visual Inspection Results: Facade: Inspected Debris North ❑ N/A ❑ Yes ❑ No ❑ No VsiblefFine Layer ❑ % to 1" 0>1" South ❑ N/A ❑ Yes ❑ No ❑ No VSible/Fine Layer ❑ % to 1" 0>1" East ❑ N/A ❑ Yes ❑ No ❑ No ViSible/Fine Layer ❑ % to 1" 0>1" West ❑ N/A ❑ Yes ❑ No J No VSible/Fine Layer ❑ % to 1" ❑ > 1" Facade Description:

Roof

Debris: No Visible /Fine Layer ❑ va to 1" ❑ > 1" Description:

Setbacks N/A ❑ Floor Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor, Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to V 0> 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ h to 1" ❑ > 1" Floor: Debris: ❑ No Visible/Fine Layer ❑ % to 1" ❑ > 1" Comments

Date: / f—1 b02 Inspection Team: Name: Agency: Name: Agency.

NYC-WTC 000118318